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Organization

WYATT & JACKSON CENTER FOR CHANGE, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MOLLIE L. WYATT PH.D. (OWNER)
(601) 981-8846
Entity
Organization

Contact information

Practice address
2637 RIDGEWOOD ROAD SUITE 100, JACKSON, MS 39216
(601) 981-8846
(601) 981-8873
Mailing address
2637 RIDGEWOOD RD STE 100, JACKSON, MS 39216-4922
(601) 981-8846
(601) 981-8873

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary

Other

Enumeration date
06/21/2017
Last updated
07/21/2022
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